Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21-00128, Rome, Italy.
Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128, Rome, Italy.
Arch Orthop Trauma Surg. 2023 Nov;143(11):6821-6828. doi: 10.1007/s00402-023-04882-2. Epub 2023 Apr 16.
Total hip arthroplasty (THA) is regarded as one of the most successful and cost-effective orthopedic procedures. However, THA is a surgical procedure with potential intraoperative and postoperative risks. Dislocation is one of the common postoperative complications and remains one of the main indications for THA revision. The purpose of this systematic review was to evaluate the role and the outcomes of dual-mobility implant to prevent dislocation in patients younger than < 55 years in primary THA. In this systematic review, we included observational, prospective, and retrospective studies that evaluated the outcome and the complications of the dual-mobility cup in < 55-year-old patients. After applying exclusion criteria (femoral neck fractures or THA revision, case series, reviews, and meta-analyses), ten articles were included in the study. The overall number of participants in all the studies was 1530. The mean age of the participants was 50 years. The mean follow-up was 11.7 years. A total of 46 patients (2.7%) reported intraprosthetic dislocations, in which the polyethylene liner dissociates from the femoral head, while 4.8% of revision was due to aseptic loosening. The mean revision rate at twelve years was 11%. The mean value of Harris Hip Score increased from 50.9 pre-operatively to 91.6 after surgery. Dual mobility is a valid option for young patients with extended survivorship and low rates of instability and dislocation after primary THA.
全髋关节置换术 (THA) 被认为是最成功和最具成本效益的骨科手术之一。然而,THA 是一种具有潜在术中及术后风险的手术。脱位是常见的术后并发症之一,仍然是 THA 翻修的主要指征之一。本系统评价的目的是评估双动植入物在初次 THA 中预防 <55 岁以下患者脱位的作用和结果。在本系统评价中,我们纳入了评估双动杯在 <55 岁患者中的结果和并发症的观察性、前瞻性和回顾性研究。应用排除标准(股骨颈骨折或 THA 翻修、病例系列、综述和荟萃分析)后,有 10 篇文章纳入研究。所有研究的参与者总数为 1530 人。参与者的平均年龄为 50 岁。平均随访时间为 11.7 年。共有 46 名患者(2.7%)报告了人工关节内脱位,其中聚乙烯衬垫与股骨头分离,而 4.8%的翻修是由于无菌性松动。12 年时的平均翻修率为 11%。术前 Harris 髋关节评分平均为 50.9,术后为 91.6。双动是年轻患者的有效选择,具有延长的生存率和较低的不稳定和脱位率。